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Saturday, May 9, 2015

As we approached the river entrance a small open boat pulled out of the river. We flagged it down and asked if they needed any medical aid. They indicated that they did, and we asked if the chief was at the village. It turned out he was the guy manning the outboard. He said he would go in and let the people know, and that he gave his blessing for us to visit the village.We took our dingy up the river dodging upturned logs and large rocks. The waves surfing us in just added to the excitement. When we arrived we were greeted by a group of smiling faces. We were given a tour of the village and learned that all their homes had blown away, that they had hidden in the two concrete structures, and that when their houses blew away everything that they owned went with their homes. Not once though did they ask for anything.All their crops had been destroyed, and I asked when they had last received food, they said about 40 days ago and that it was all gone. They were just eating roots, and the island cabbage that they planted after the cyclone was just getting big enough to eat. So we off loaded about 1000lbs of rice we had brought from American Samoa and about 400lbs of split peas one of the other boats (Salsa) had brought from Fiji. And of course peanut butter, corned beef, crackers, fishing line and hooks.Everyone in the village helped carry it up the hill even the old ladies with one bag of rice on their head, and a bag of split peas under one arm. The people worked very well together.This was one of the strongest communities that we have met. Most of their houses had been put back together enough to shelter them from the rain, and the people were strong and healthy.Courage

Friday, May 8, 2015

Busy day, crossed from Tanna to Erromongo. The boats split up so we can do everything we are supposed to on Erromango in a short few days. Kim and I saw about 40 people today after a 5 hour crossing. We went in from about 1-5, then returned from 6-8 to care for the outlying villages that walked down for hours to see us. It would be a shame for them to walk that far and not get seen. All in all successful day, nice visit. We leave early tomorrow morning to Ponkil to do a clinic there with the other boat Salsa hopefully at 10 am. There may be 2 local girls here who come with us on the boat. If they are onshore at 6:30 am, they come. If not, it's about a 3 hour walk (or more). Goodnight,Shannon

Thursday, May 7, 2015

So yesterday we went for a walk in the rain. We were meeting with the chiefs daughter who had lost half her foot to an infection. We had "borrowed" some crutches, and Salsa another Sea Mercy boat with us, had some shoes for her damaged foot. We got her to take her first steps in 1.5 years! Hopefully the family will encourage her to continue to try walking.As we were walking home we found that even though the temperature is 75 degrees, the rain made it so cold we were shivering. Now the question (Bet) that we have is how fast does a body lose heat when in 30 degree water versus 30 degree air. Is it 10 times faster? 2 times faster?Enjoy,Courage

Wednesday, May 6, 2015

So today we started by going to see if anyone showed up in the pouring rain for the clinic we had scheduled for this remote town of Lavis. Monday we tried to do a clinic there, spent most of the day trying to get there by boat, truck and foot, then everyone was gone getting food aid when we arrived. So we said we'd be back today. We think they don't keep the same "schedule" that we do, but we felt obligated to show up.Courage, Cassidy and Steffan went up the hill in the rain after I landed them on some jagged reef rocks in the wind and rain. They went up, dropped off some medications, borrowed some crutches, checked for any patients, then returned. We were all soaked! I just stayed in a swimsuit since I wasn't going to town. No patients came out in the rain. I think they have a hard time getting dry again in their dwellings, or caves, depending on where they are living now.So, we came back, had lunch and dried out. Then we headed back out in the wind and rain to visit our friend at the local village with the partially amputated foot. We brought more clothes, plastic jugs, and kitchenware from our boats for them, and the crutches. We only had them on loan for a day, so we had to see if it was a viable option. Ellinor (Dr.Ristoff) from S/V Salsa brought a pair of Crocs and a pair of Tevas. Due to the deformity of her foot, it turned out Tevas were the only ones we could get on her foot. She had not been ambulatory for a year and a half. She is 21. So getting up was hard, I basically lifted her. We propped her on crutches, but her balance wasn't great, so I caught her a few times. I handed her off to Ellinor as she walked out of her house and Ellinor supported her while she made her way. She fell to the side a few times, but did great! Due to the rain, and the fact that she has muscular atrophy now due to disuse, we only went a little ways. We turned her and worked back to the hut she was in, got her settled back into bed. She was very happy to have an option to be mobile. She was shivering since she got somewhat wet. I pulled out and gave her one of Courage's sweatshirts that he was donating to them and she slipped it on. Turns out her father was the chief. He was so excited to see her up. He offered us a chicken, yams, and island cabbage. The woman was holding the chicken, but we declined it as nicely as we could. I don't see plucking the thing. We still had yams from their previous gift, so we accepted the greens and called it good.We are supposed to return the crutches tomorrow when we go up to run the clinic. I have a request out to Dr. Moise, the local physician and apparently health coordinator for all of the Tafea Province. He is going to drop off some medications for us to deliver to Erromango on our next tasking trip. I have asked for crutches to be brought also!! I sure hope he has some. It is very hard for these guys to get to Lenakel to pick them up, so I am hoping he can bring them out here with his truck when he comes with the medications. I told him that we or Sea Mercy or someone would buy them if it was a money issue and the government doesn't provide them. If he is unable to get us some, maybe we can buy them from Mary at the Aid Post whom we borrowed them from?? I am quite excited for Yao, the girl, to get mobility after a year and a half. I told her my major concern for her is atrophy of her muscles, bedsores, and pneumonia. I told her she'd grow old quick if she doesn't find a way to get up moving. She was certainly interested and willing, so my task is to get her those crutches.We brought all the children to shore with us since it's been raining for days and we haven't really been out. I think it was good for them to meet the villagers, see the donations, see their gratitude, and get outside for a little bit. But they were blue and shivering when we returned. We had hot chocolate and cuddled in dry blankets. Our cockpit and lifelines are filled with things "drying" after almost a week of rain. Rumor is there may be a break in the rain tomorrow. Would be great to be able to dry everything out, even if only for a day!! Get it put away, and then start accumulating wet again. The winds have picked up again this evening; maybe it's blowing the storm past us??Today one of the little girls was wearing Vitality's old dresses. I hope they are wearing their sleepers we gave them for tonight. Those palm leaves are really no protection from the wind and rain. The overhang is only a shelter as long as the rain comes straight down or from behind it. Not if it is blowing toward it.This is definitely a hearty population that does not complain; at least not to us.Goodnight,Shannon

Tuesday, May 5, 2015

Today we attempted the Greenhill clinic. The truck was to leave Lenakel around 8am, so we watched through the rain for about an hour for the truck this morning. Then Cassidy, Courage and I went to shore with all our medical supplies and started to walk to the village south of here where the inhabitants came, welcomed us to their beach, and told us their entire village blew down. We made their village before the truck came (the truck never came due to the rain). We saw the overhangs and caves they were living in with their few recovered material possessions. They had a single brick house, which only had 2 x 3 foot tall walls standing left. Everything else was gone. The family started in the house, then ran to another thatch shelter until it fell, ultimately ran to caves in the hills to hide with the pigs. The caves they live in now were below the wave surge line.They have rebuilt a single house that stores their food aid and a generator he had that survived. Half of that floor was dry with woven mats on it. The other half was muddy. The roof did not leak and it was pouring rain, so that was nice, but the bamboo siding let in light, so I imagine if there's wind with the rain it comes in the sides too. They have found a few of their pans, only have the shirts that were on their backs, but somehow they have mosquito netting which it sounds like they have from before. They are living under overhanging rocks. There were some palm leaves enclosing a shelter with woven mat flooring, 3 mosquito nets up, a single woven basket and a one pint plastic bottle of water. When we originally walked up to the "village" we saw the women with the children under an overhang with a pan of cooked yams they were sharing. They spoke no English, so sent us over to the men.There was another rock structure with a roof and metal siding walls, but the roof was flat with palm leaves (no slope), so it leaked despite the fact that it also had a tarp on it. There were 2 mosquito nets up and there was one foam mat that was soaked. There was a girl in there that had stepped on a bottle a year and a half ago. I think she did not get care right away, so it got infected and became osteo. She had surgeries in Port Vila and her lateral 3 metatarsals were missing, then there was a somewhat crude skin graft/flap of her lateral foot to cover the wound. It was healed and not infected, but bumpy and didn't look like it would tolerate much pressure across the wound. She had a wheelchair beside the "house", which was just laughable. I guess if they give it to you, you keep it. But it's hard enough to get around on this terrain with two feet stable; there is NO place that a wheelchair could go around here. A 4x4 truck could not even pick us up on the road. I looked at the wound, and then wrapped it back up. We had some donated ACE supports for elbows onboard, so I brought one and we made a nice covering for her foot rather than the torn up sheet she had. She was pretty excited. When they heard I was a doctor, they asked if we could leave some medical supplies because it's so hard to get medical care here. They have to walk to the airport where they can catch a truck to Lenakel, but then it's a long wait too. We gave them a basic first aid kit - antibiotic cream, Band-Aids, gauze, antibacterial soap, toothbrushes and toothpaste (theirs blew away), and Tylenol. My goal is to see if we can get her up using crutches or something, maybe with a platform shoe? I don't know, but she's 20-30 years old and is going to get pressure sores and pneumonia if she sits in a wet house and does not/cannot move. I noticed a girl at the village we went to yesterday had some crutches. We may go to tomorrow (but it's pouring rain and we went straight up a muddy hillside to get there yesterday) and I will see if I can get them?? Otherwise, maybe we can build some.It is a little hard to understand why they have one house after 6 weeks. It takes maybe 3-7 days to build a local house as we've been told. Working hard of course, but it's possible. A charity came through, gave them some corrugated steel and built a 12x12 structure with a roof, but no walls. They are collecting water from the roof, but only 3 streams of it into a 3 gallon bucket, they have no gutter on it. Courage gave them a 4-inch plastic tube they can cut down the side, attach to the roof, and then collect much more water. They used to walk to a river to get water, but their plastic bottles are all gone. We brought them some old, empty jugs we've been keeping as we use up food items, but if they can collect water onsite, they won't have to walk it all over the place. They had wood, fallen corrugated steel, a little new steel, and surrounding leaves they use for roofing all laying where the houses used to be.

They indicated the main reason they have not built is that they didn't have nails. Courage asked where his hammer was and he said, that's another reason, they have no hammer (but they can use their machete to pound nails in if needed). He also asked for an axe. We don't have an axe, but gave him a large machete that made him happy, a hammer, and nails. He said when he was staged; he could get family from the hills to come help him build. Courage lent them a metal file to sharpen their tools, and we hope they are ready to rebuild their village.They said they went to town and got some hooks, but didn't have fishing line. They normally fish when they can for food, but also have some farming on the hillside. We gave them some more fishing supplies and we have seen them out fishing, so we know it is getting good use.Finally, I have clothes on the boat that the children have outgrown. All of them were wearing pretty well worn out clothing. Some clothes were drying on the rocks (but it was raining, so not going to happen this week probably) and they were so thin, faded, with holes. I'm sure they've worn these for a long time. I gathered together a couple of bags of clothes, mostly for the children, a few for the men and women, and brought that in. They were quite happy, I'm curious to see if they are wearing them when we come back. There were also a bunch of sleepers since they are basically sleeping outside in the rain and elements each night. There were only 3 children here now, but another family went to the hills to visit family when a truck came through the other day. There are normally 4 families and 8 kids here, so we left extra.They asked us for an American flag, so maybe tomorrow we'll bring them one. They were very appreciative and while we went to gather the things, they sent some girls up to the farm who came back with a wonderful yam. They were sure they had enough food and that it was OK. It was 10-15 pounds and plenty for all 3 boats to split it. We cooked it up like a potato for dinner tonight and it was quite nice.Again, not the day we'd planned at all, but a very interesting day overall. We have learned a lot, we have resupplied them with "stuff", and hopefully solved some of their problems. Our biggest benefit I think would be outfitting this girl to walk, maybe with a homemade platform shoe and crutches. We did not address it with her, as it was more of an afterthought. I don't want to put her at risk for falling though and getting more hurt, but I think her life is basically over if she can't move. . . When discussing with her, she is not able to be mobile. We knew the wheelchair was useless. I also did not ask her where she was during the hurricane? Did family just carry her as they ran from place to place?? I bet that's a fascinating story.Shannon

Someone commented that the way these people are living is similar to the song ‘Imagine’ by John Lennon. It's a great song and a beautiful concept, but it's not human nature and the people here are human. It's not the possessions that make people crazy; it's the crazy people managing their possessions. You can have an old plastic jug, tattered clothing, and not much else, but still want other people's things, still protect your things, etc. The people here have been very appreciative of all donations and items; that is not an issue. And it's a reciprocal culture, so they are quick to find a gift of some sort in return. We have gotten a gorgeous wood carving walking stick with a 3D snake on it, a woven fan, a woven basket, green beans, and a HUGE yam. But while the people are sharing, getting by with very little, not starving despite being wiped out, not complaining of lack of shelter, food, fresh water, clothing, there are stories of jealousy and anger also. People are people. "Imagine there's no hunger." These people are very resourceful and definitely to be appreciated for their skills in this area. They have grown their root crops and no one is starving, which is so wonderful to see. There may still be hunger as there are long lines for rice and meat food aid. I think it's also a rare food that most of these villagers never get access to, and it's nice to have the variety for them, so they are hungry for it. And the variety is probably good to develop a well-rounded nutrition for them as they have a very repetitive diet. The food aid goes out like a communistic society - exact same for every man, woman, and child, even an infant gets the same rations. You must sign for it and collect ALL of it in one trip. You cannot carry out your rice, and then come back for your cans. They don't want people randomly returning asking for things they didn't yet receive. The people are definitely happy for it, but it's quite a commitment. They walk for hours sometimes since the trucks can't make it to the villages, then wait for hours for the trucks to arrive, everyone to check in so they know how much to distribute, then distribute it to everyone, then walk home for hours with heavy sacks. Is this the dream of the song? It's the practical side for sure. Those who can, help those in need. It would be sad indeed if this disaster now left the people dying of starvation. But that does not appear to be the case. Hopefully the crops will be back in full force soon and the food aid will no longer be "needed". Of course bananas, pineapples, and other things take a year to grow. Mangos, limes, and other trees take years. So variety will be a long time coming for them. But does "imagine no hunger" mean feeding them until they have a full variety? And when do we now make people dependent? Fascinating to consider to me. How do you "help" without making things worse for a society in general? Decreasing their motivation to rebuild on their own? Replant on their own? Work for a living, etc.?Apparently a man was told the food aid was coming a different day, so he was upset after walking for hours and getting nothing. He reportedly was lighting the hillside on fire his whole walk home. Reports from people who have been here for a while and are more insiders indicate a decent level of jealousy amongst villages or families. If one receives and the other does not, etc. This is partly why all donations go to the chief, and then the chief decides who needs it more or who deserves it, or whom he likes better? After all, he's human too with a nature of his own. We have been quite impressed though with the chiefs in general. They appear to be looking out for the community, not selfishly employed.But I believe that human nature is the same whether you have a lot or a little of material possessions. If you are middle class, do you covet the upper class, or do you not want to work that hard and worry that much about "stuff"? If you are poor, can you not be happy with what you have? Of course you can. Let's not blame the possessions for our personal faults. I don't think you need to "imagine no possessions" to make people the same on a fundamental level. "Imagine all the people, living life as one." As the world travels more and more and it gets easier and easier, I think we'll find it is possible for people to relate to people of completely different cultures and backgrounds. But I don't think we'll ever find everyone being "the same". It doesn't make sense. Some people want to have very little and do very little. Others are movers and shakers that want to be productive, feel useful, and see that they have accomplished things and left this world a better place for them having been in it. That's OK too. Then there are those with a destructive force. That's less ideal. But people are different by nature and I don't think we need to/want to try to make them all the same, take what they chose to produce, change their nature to be like everyone else (unless their destructive, then we need to channel that or isolate it to their own property), remove their spiritual beliefs, etc. So while it's a great song, aiming at a lovely goal, I think it's completely misguided, inaccurate, and impossible.Shannon

Today as we were walking to a rumored blown away village (Uvien). We came across these ladies with a few children sitting under a giant rock. We tried talking to them, but they just smiled, giggled, and pointed us over to where the men were under some tarps. They were the people without any homes. Everything had blown away. The gave us a tour of their "village", and the only remains of their homes were rectangular areas of crushed white coral showing where their floors had been. The mango trees that had surrounded their homes were reduced to a trunk and a few stubs of the larger branches. New leaves were popping out everywhere, but it is going to be a while before there are any mangos.They told us how after the hurricane started they huddled in their cinder block house, when the roof blew off, and the wall collapsed they moved to one of their bamboo and thatch houses, until it collapsed on them. There were no other houses so they headed up the hills to hide in small caves where they had hidden their chickens and pigs.We asked what they needed to start rebuilding their homes. "Hammer, nails, and an axe!" Chez Nous and Salsa immediately sprung into action, and brought a large machete, hammer, an old butter container filled with nails, a spool of fishing line, and bunch of hooks. Shannon had also whipped together a bag of children's clothes that our children no longer wore.They were more than appreciative, and they forced us to take one of their giant yams. It was about 10 to 15 lbs.We also did a quick medical clinic there as one of the young ladies had stepped on a broken bottle and ended up losing half her foot to an infection. It was healing well, but very sad.Once again these wonderful people did not ask for anything, but rather graciously accepted our offer of help. So refreshing!Courage and Crew

Monday, May 4, 2015

The three doctors, and two of the captains went out in a 4x4 truck yesterday to put on a medical clinic in a quite remote area. The road was rumored to be out but 'what could go wrong!' The squalls are continuous so every hour or so warm rain comes down to keep everyone cool. The road though gets muddier and muddier. The roads are steep up and down, and carved into the sides of the fertile hills.As we were sliding down the roads and and looking off the cliff everyone started getting less and less comfortable. After getting quite stuck, and only getting out after putting branches and leaves in front of all the tires, and having everyone push, we started evaluating the 'going back home option'.Ultimately we gave up and managed to find a local who could guide us if we took our boat. So off we went with Lil' Explorers, 5 adults, a guide and 8 children. It is always an adventure here!Courage

Today we planned to take a truck and do a clinic in Lavis as recommended by Dr. Moise, by Lisa (a passing college student), and having met Mary, the aid post worker out there at the distribution of food for Samaritan's purse near Hebron. We were onshore at 8 am, but no truck came until about 10 am. In the meanwhile, we met a 35-year-old man with a leg wound who was walking to Lenakel for fuel. We dressed his wound and gave him Azithromycin for YAWS as he had many wounds. Then a group of school kids came walking from their villages to Lenakel. They each had many leg wounds, which were dressed and they were all given Azithromycin for YAWS. There were 5 16-year-olds, 4 males and one female. They are all the same, so no need for a chart on this one.At 10 am the truck came and we headed off with intermittent rain. We got stuck a couple of times, got out, put leaves and branches under the tires, pushed the truck and got it up the hills. Then we had torrential rains while the driver and Jonathan were out walking the road to see if we could make the next hill. We decided it would not work, considered walking, but school kids told us one hour, but adults told us 3-4 hours walking in rain and mud carrying buckets with our supplies. It was 11-12 am, so we would arrive quite late that way and still not have a plan to get home, so we turned around.At the village we passed (by the Bible College) there was a food distribution going on. People from Lavis were there to get food among many other villages. We saw a 7 year old with a wound on his foot. It appeared to be impetigo, so we recommended wound care and antibiotic cream.We went back to the boats to try another approach. We got a man from Lavis at the food drop, put his food in the truck and brought him with us to the boats. We were feeling bad that we'd sent word to a town that we were coming, and we had not made it, so we took Lil' Explorers up to the cliff in front of Lavis with the local guide showing us where to go. We then anchored and took the dinghy to a reef where we offloaded into the water and walked on the reef to shore. We then hiked what felt like straight up a cliff on a narrow muddy, wet path, to join the main road. Once on the main road, it was muddy, but flat and we walked a while to the village. At the village, we met Mary, who we had given our "medical unit" pack to. We asked about her aid post and supplies. She has NONE except what we gave her. The houses here were very much devastated and everything standing is new construction. The aid post completely blew away (except evidence of a toilet from an outhouse and the front sign saying aid post). Mary lives right across the main road and does not hold regular clinic hours, but people just come to her if they need something. All her medications and supplies blew away and she understands that she cannot get more because she does not have a building. She has a case that she would keep them in and she can keep them at her house at this point until an aid post is rebuilt. People come to her house for help, but she has nothing to treat them with except our medical unit, which can treat wounds, but not a lot more. They have no building supplies and have been busy clearing roads, rebuilding their houses, replanting, etc. so the aid post has not been done yet. If we can help her get an aid post built ('Samaritan's Purse') and get a restock of medications ('Dr. Moise') I think we'll do much more good for her and for the community than seeing a few patients. Right now they face the same issues getting to Lenakel for medical aid as we faced getting to Lavis and they have no medical aid nearby otherwise.We asked if anyone needed medical aid, but everyone had gone to pick up rice and meat at the food distribution site, so no one was in the village. Also, no one had gotten the message. These word of mouth messages so far are a huge bust! No wonder the Internet and other communications have thrived!!We saw a 40-year-old man with a 5 cm laceration on his right anterior tibia region. It was 2 weeks old unfortunately. It was a clean cut from a machete, so could have closed well. It was not infected, but weeping. We cleaned the wound with Betadine, debrided some surrounding dead skin, dressed with neomycin and gauze. We then gave him neomycin and gauze to keep it clean while it heals.Final patient, on our scamper back down the hillside, we took another easier path by the blue reef resort. Lisa's mother, Mary, works there. She is probably 50. She had a mass removed from her left jaw line one year ago in Port Vila. She thinks it was a cyst, but is not sure. It was supposed to go away, but it has regrown at the scar line. There were multiple smooth, nodular masses. 2 pre-auricular and one submandibularly near the far end of the scar. While they were well circumscribed, which is usually a good sign, they felt very firm and fixed, not freely mobile. They were not fluid filled like a cyst, so I do not want to put a needle in it to drain it. I have some concern that it potentially could be cancerous. She otherwise feels fine, but there is distinct swelling to that side also. We will give her Paracetamol when we return Wednesday since we were on the wet rocks ready to load into the dinghy and it would have been a disaster to be messing with pills. She was fine with that, but we told her she needed to return to Port Vila.We decided to figure out if we could help them restock their clinic and set them up with a plan to rebuild it, that we would return Wednesday to do a clinic. We told Mary, our local guide, Lisa's mom, and as many people as we could to tell EVERYONE in surrounding villages that we were coming Wednesday. Maybe if we are not competing with food, there will be a need. Clearly they don't have many resources in this area.At this point we gave up. We went diving in the Blue Cave, which was cool. At low tide you dive under an opening in the rocks into a large cave with an open top due to a cave in, so you can see light and trees above. We swam with many of the children there, and then motored back to the anchorage. Since we had the crew of Salsa (the Swedish family) onboard and were making dinner already, we had them over for dinner, and then we had a game night, which was a lot of fun. By 7 pm we were all ready to call it a night!!!We had a fun fiasco trying to do a clinic in Lavis. We faced the issues the locals face in trying to receive care. We enjoyed the experience and will try again Wednesday. In the meanwhile, Jonathan has set up a clinic for us tomorrow by truck to go with the food distribution to Greenfield where there is a well-stocked aid post. Kim and I will be going to that.Shannon

Sunday, May 3, 2015

The difference between the chiefs on Aneityum and Tanna is noteworthy. In Aneityum the chiefs speak through a 'helper' but do not speak directly with the visitors. Here on Tanna the chiefs give a handshake and speak directly with the visitors, and I can ask directly if it is ok to run a medical clinic, and if it is ok to be on their land.There is also this strange phenomenon where there are blond black people here. Their hair has the same tight curls, but is very light. Rumor here has it that this is one of the only places that there are blond black people. Now there are only a small number of blonds maybe 10%, but they do really stick out.For those of you looking at the weather the wind is howling, and the waves are crashing, but here in our harbor the water is nearly flat, and there are only gusts as the squalls pass.Tomorrow we are off in a 4x4 to do some more remote clinics. As most of you know our cousin Kim is with us, and she is a chiropractor. There is a high demand for "adjustments". I think they relate with the concept of 'healing hands' and believe in the concept of being healed by touch and magical powers. My understanding is that as we move north this will become stronger and stronger. Even in our brief visit to Fiji we were told about the magical powers of the Vanuatu people.Courage